Dear Neil,
You don't know how much I appreciate your responding so quickly. That was so kind of you. I am truly grateful.
I do see that you know a lot about aplastic anemia.
To answer your question, my mother had two different biopsies of her bone marrow. The first was about 5 months ago. And the second was about 4 months ago. Let me tell you the story: She had an initial biopsy at a small hospital. The hematologist she was seeing basically ruled out all blood cancer except lymphoma. But then said, it would take several more weeks to get a diagnosis because more of the bone marrow needed to be analyzed. So, in the meantime, my mother developed severe jaundice. She was rushed to a city research hospital where she was diagnosed with a drug-induced liver injury (DILI) caused by the antibiotic Augmentin. They said her liver would be just fine and that no medication would be necessary. They then decided to bring in the hospital's hematologist team to diagnose her the cause of her anemia. The top hematologist said that the first biopsy was inconclusive but almost knew for sure that she had either aplastic anemia or MDS. He then proceeded to have her do a second bone marrow biopsy (one that was super thorough). 4 days later, he comes back and tells her that she definitely has aplastic anemia - 100%. He suspected MDS because of her age, but said that he scrutinized the marrow and no presence of MDS. He thought the the first biopsy was terribly done and said that he really had to scrutinize the bone marrow to distinguish between aplastic anemia and MDS because of her age. She was told that aplastic anemia normally doesn't strike people her age in general, but it does happen. Another hematologist spoke to her a day later at the research hospital and acted like her age didn't matter that much so much because she was in a very good health overall. The research hospital then referred her to her current hematologist who talks about her age all the time.
The only thing I know is that she is getting blood transfusions less often as her levels don't drop near as fast (every two weeks instead of one). It's only been 12 weeks since ATG. I have no idea why her current hematologist is jumping the gun like this.
We're already talking about rabbit ATG and a bone marrow transplant at 12 weeks. It's hard to stay in the present moment.
You're right: knowing the cause of the disease is not going to help now. She is not supposed to ever take naproxen again, however. The doctors said "no more", as that may have been a trigger. Also, she took benzo sleeping pill for many years, and that doctors were not happy about that, either. Naproxen and Restoril (benzo) + Covid-19.....all of those can easily induce aplastic anemia in vulnerable people.
By the way, what are other treatments are there for aplastic anemia besides horse and rabbit ATG/cyclosporine, if not a BMT?
Again, I am super grateful for your post. May you be well, Neil.
Best wishes!